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General NPI Number Information
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NPI Number | 1295786226
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Entity Type | Individual
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Provider Name | ROBERT JEROME BLAIR II PH.D.
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Gender | Male
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 11/29/2011
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Provider Practice Location Address
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Address Line | 252 S STATE ST
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City | NEWTOWN
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State | PA
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Zip | 18940-3511
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Country | US
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Telephone | 215-579-8620
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Fax | 215-579-1910
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Provider Business Mailing Address
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Address Line | 252 S STATE ST
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City | NEWTOWN
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State | PA
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Zip | 18940-3511
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Country | US
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Telephone | 215-579-8620
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Fax | 215-579-1910
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS004500-L
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License Number State | PA
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